Achalasia can affect people of all ages, but it is most common in adults between the ages of 40 and 60. It is slightly more common in men than women.
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Achalasia is a rare neuromuscular disorder that affects the esophagus, the muscular tube that connects your mouth to your stomach. In achalasia, the muscles in the lower part of the esophagus (the esophageal sphincter) do not relax properly, making it difficult for food to pass into the stomach.
How Achalasia Presents Itself
Achalasia can cause a variety of symptoms, including:
Difficulty swallowing (dysphagia): This is the most common symptom of achalasia. People with achalasia may have difficulty swallowing both solid foods and liquids.
Regurgitation: Food or stomach acid may back up into the esophagus and into the mouth. This can cause heartburn and a sour taste in the mouth.
Chest pain: The pain may be located in the center of the chest and may worsen after eating.
Weight loss: Due to difficulty swallowing, people with achalasia may lose weight.
Common Scenarios
People with achalasia may experience the following scenarios:
Difficulty eating out at restaurants due to the need to eat slowly and carefully.
Avoiding social situations that involve eating.
Experiencing anxiety or depression due to the challenges of living with achalasia.
How You Can Help Yourself
There are several things you can do to help yourself manage achalasia, including:
Eating a soft, bland diet: This can make swallowing easier.
Eating small meals throughout the day: This can help to prevent regurgitation.
Drinking plenty of fluids: This can help to prevent constipation.
Elevating the head of your bed: This can help to prevent regurgitation at night.
Taking medications: There are medications that can help to relax the muscles in the esophageal sphincter and make swallowing easier.
Why Do People Get Achalasia?
The exact cause of achalasia is unknown, but it is thought to be a combination of genetic and environmental factors. Some research suggests that achalasia may be caused by a virus or an autoimmune disease.
Genetics
Achalasia is not typically inherited, but there is some evidence that it may be associated with certain genes.
Lifestyle
There is no known lifestyle factor that directly causes achalasia. However, certain lifestyle factors, such as smoking and alcohol consumption, may worsen the symptoms of achalasia.
Who Gets Achalasia?
Achalasia can affect people of all ages, but it is most common in adults between the ages of 40 and 60. It is slightly more common in men than women.
Symptoms of Achalasia
The symptoms of achalasia can vary from person to person, but some of the most common symptoms include:
Difficulty swallowing (dysphagia)
Regurgitation
Chest pain
Weight loss
Heartburn
A sour taste in the mouth
How Achalasia Can Affect Lifestyle
Achalasia can have a significant impact on a person's lifestyle. The difficulty swallowing can make it difficult to eat and drink, which can lead to malnutrition and dehydration. The pain and discomfort can also interfere with sleep and daily activities.
What Can You Do to Treat Achalasia?
There is no cure for achalasia, but there are several treatments that can help to manage the symptoms. Treatment options include:
Medications: There are medications that can help to relax the muscles in the esophageal sphincter and make swallowing easier.
Botulinum toxin injections: Botulinum toxin injections can be used to temporarily paralyze the muscles in the esophageal sphincter.
Balloon dilation: This procedure involves inflating a balloon in the esophagus to stretch the muscles in the esophageal sphincter.
Surgery: Surgery is usually only considered if other treatment options have failed. The most common type of surgery for achalasia is Heller myotomy, which involves cutting the muscles in the esophageal sphincter.
Diagnosing Achalasia
How is it diagnosed?
Diagnosing achalasia typically involves a combination of medical history, physical examination, and diagnostic tests.
Medical history: Your doctor will ask you about your symptoms, including when they started, how severe they are, and how they affect your daily life. They will also ask about your medical history, including any family history of achalasia or other esophageal disorders.
Physical examination: Your doctor will perform a physical examination to check for any signs of achalasia, such as enlarged lymph nodes or an enlarged liver.
Diagnostic tests: There are several diagnostic tests that can be used to diagnose achalasia, including:
Barium esophagram: This test involves swallowing a liquid containing barium, which is a white chalky substance. The barium coats the lining of the esophagus, making it visible on X-ray images. This test can show narrowing of the esophagus and the failure of the esophageal sphincter to relax.
Esophageal manometry: This test measures the pressure and contractions in the esophagus. It can show that the muscles in the lower esophagus are not relaxing properly.
Endoscopy: This test involves inserting a thin, flexible tube with a light and camera at the end (endoscope) down the throat and into the esophagus. The doctor can use the endoscope to look for any abnormalities in the lining of the esophagus, such as polyps or ulcers.
What is the procedure?
The diagnostic tests for achalasia are typically performed on an outpatient basis, meaning you can go home the same day. The procedures are generally safe and well-tolerated.
Barium esophagram: The barium esophagram takes about 30 minutes to complete. You will be asked to drink a liquid containing barium and then lie down on a table while X-ray images are taken.
Esophageal manometry: The esophageal manometry takes about 15-30 minutes to complete. You will be asked to swallow a thin tube with a pressure sensor at the end. The tube will be placed in your esophagus, and the pressure sensor will measure the pressure and contractions in your esophagus.
Endoscopy: The endoscopy takes about 30-60 minutes to complete. You will be given medication to relax your throat, and the endoscope will be inserted down your throat and into your esophagus. The doctor will use the endoscope to look for any abnormalities in the lining of your esophagus.
How long does it take to diagnose achalasia?
The time it takes to diagnose achalasia can vary depending on the availability of diagnostic tests and the expertise of Mr Veeramootoo. In most cases, achalasia can be diagnosed within a few weeks.
Possible outcomes
The diagnostic tests for achalasia are highly accurate. In one study, the barium esophagram was 90% accurate in diagnosing achalasia, and the esophageal manometry was 95% accurate.
Pre-diagnosis and post-diagnosis
Pre-diagnosis
Before being diagnosed with achalasia, you may experience symptoms such as difficulty swallowing, regurgitation, chest pain, and weight loss. These symptoms can be caused by a variety of conditions, so it is important to see a doctor to get a diagnosis.
Post-diagnosis
After being diagnosed with achalasia, there are several treatment options available to help manage your symptoms. Treatment options include medications, botulinum toxin injections, balloon dilation, and surgery.
Long-term effects
The long-term effects of achalasia can vary depending on the severity of your symptoms and how well you respond to treatment. With proper treatment, most people with achalasia can live long and healthy lives.
Achalasia Surgery
What does it involve?
Achalasia surgery is a major operation that involves cutting the muscles in the esophageal sphincter to allow food to pass more easily into the stomach. The most common type of surgery for achalasia is Heller myotomy.
Heller myotomy is typically performed laparoscopically, which means that it is done through small incisions in the abdomen. During the procedure, the surgeon will insert a laparoscope, which is a thin tube with a light and camera at the end, into the abdomen. The surgeon will then use the laparoscope to guide surgical instruments to the esophageal sphincter. The surgeon will then cut the muscles in the esophageal sphincter, allowing food to pass more easily into the stomach.
What to expect after surgery
After achalasia surgery, you will typically stay in the hospital for a few days. You may experience some pain and discomfort after surgery, which can be managed with medication. You will also need to follow a special diet for a few weeks after surgery.